Migraines Vs. Headaches: Differences, Similarities, And Treatments

When there's all that pressure and pain in your head, it can be difficult to tell if you have a migraine or a typical headache. Don't just write off the unpleasant experience as another headache. There's a lot to be gained in knowing the difference between the two. After all, better treatments result in faster relief. 

Understanding both could also mean preventing these conditions from developing in the first place.

What is a headache?

We've all had headaches at one point or another. They are unwanted pains in your head that sensations of pressure may accompany. The ache may range from mild to unbearable.

While they normally develop on both sides of your head, they may also occur in specific locations such as the temples, forehead, and the back of the neck.

Headaches are sometimes more complicated than you realize. There are more than 150 different types of headaches, and the different varieties have unique causes, symptoms, locations, and treatments. Identifying the pain areas and the nature of the aches may help chart a court of treatment and determine effective preventive measures.

Headaches can be classified into two groups – primary and secondary headaches.

Primary headaches aren't caused by a different medical condition and develop independently. They include migraines, tension headaches, and cluster headaches.

Secondary headaches, on the other hand, are caused by chronic medical conditions and illnesses that affect one's nervous system. A few causes of these kinds of headaches include brain tumors, strokes, medication withdrawal, seizures, leaking spinal fluid, and head trauma.

Common types of headache and their causes and symptoms

The most common types of headaches include:

Tension headaches

The tension-type headache, also known as a muscle contraction headache, is arguably the most common type of headache experienced, affecting over 42%¹ of adults worldwide. Tension-type headaches feel like a pressure band of mild to moderate pain across the forehead.

There are two varieties of tension headaches — chronic and episodic headaches.

Chronic tension headaches

These happen about 15 days a month, for three months or more. The pain can linger for days or even months, and often it's more severe than the episodic tension headache.

Episodic tension headaches

These pains occur for around 10 to 15 days a month. The pain can last anywhere from 30 minutes to a couple of days.

Symptoms of tension headaches

• Depression or anxiety

• Jaw clenching

• Intense work

• Hunger

• Lack of sleep

• Sleep apnea

• Bad posture

• Stress

• Arthritis

Sinus headaches

Sinus headaches feel like a constant and deep pain in your forehead, cheekbones, or on your nose-bridge. Inflammation of your sinuses causes these headaches. This inflammation is symptomatic of a sinus infection.

The mucus you blow out will likely be thick and green or yellow, not like the clear fluids you'd otherwise get if you had a migraine or cluster headache. The pain is especially bad in the morning or when you're bending forward.

Symptoms

• Pain behind the nose, cheeks, or eyes

• Runny nose

• Fever

• Fullness in your ears

Cluster headaches

Cluster headaches cause intense pain. This severe constant, or throbbing ache typically happens on one side of your head, around, or behind one eye. They are called cluster headaches as they happen in groups, a couple of times during the day, and at the same time every day.

The National Institute of Health (NIH) reveals that they generally start between someone's 20s and 50s but can develop at any age. Men are more prone to cluster headaches than women. After lasting for around two to 12 weeks, these headaches may go into remission for several months or even years, only to come calling later.

Symptoms

• Intense pain on one side of your head

• Aches behind an eye

• A teary, red, and swollen eye on the affected side

• Agitation or restlessness

• Changes in blood pressure and heart rate

• Sensitivity to smell, sound, or light

What is a migraine?

A migraine is a neurological condition that results in several symptoms — the chief of which is a throbbing headache along one side of the head. For a minority of people, it affects both sides. Some people have repeat symptoms which medical practitioners refer to as attacks or episodes.

The pain experienced during migraines may last for a couple of hours to several days.

Migraine phases

A migraine has four phases. People with migraine may experience all or some of these stages. The four phases consist of:

Prodrome phase

This stage is also known as the premonitory phase or pre headache phase. It's characterized by painless symptoms hours or days before the primary headache hits.

Some of the symptoms include:

• Sensitivity to smells, sound, or light

• Neck stiffness

• Unusual mood changes (euphoria or depression)

• A lot of yawning

• Craving certain foods

• Fluid retention

Aura phase

An aura is a disturbance affecting a person's vision, speech, or touch. These changes in normal sensory and motor operations either precede or happen during the migraine attack. Visual auras have the following signs:

• Zig-zagging or wavy lines

• Flashing lights

• Expanding blind spots

• Blurry vision

You'll feel sensory auras as:

• A tingling or numb sensation that radiates from the arm to the face

• Changes in taste or smell

• Ringing in the ears

Motor auras tend to alter someone's ability to communicate and think properly. Motor auras can be seen when:

• Speech is jumbled or slurred

• One has difficulty comprehending what other people are saying

• It's difficult to think clearly

• You can't write words and create sentences normally

Headache phase

The pain from the headache ranges from mild to piercing. It typically starts gradually and slowly intensifies. People experiencing terrible migraine headaches may require emergency medical attention. It's not impossible to get a migraine without a headache. 

Exposure to light, smells, sound, and strenuous physical activity may worsen the pain.

Postdrome phase

The postdrome follows once the headache phase has subsided. It is characterized by confusion, exhaustion, and a general feeling of unwellness. This stage may last for a few hours to several days.

The different types of migraines

Migraines can be placed into different categories depending on their accompanying symptoms. The two major types are:

Migraines with aura

It was previously known as the classic migraine. The National Institute of Neurological Disorders and Stroke reports one in three people² who have migraines speaks of experiencing an aura before the headache begins. These neurological symptoms and visual anomalies occur around 10 to 60 minutes before the head pains and normally last for, at most, one hour.

The aura usually isn't accompanied by headache pain. These aches are, however, expected to materialize at any time. Some other symptoms of this kind of migraine include:

• Difficulty speaking

• Tingling in the face or hands

• Confusion

• Muscle weakness and numbness

• Nausea

• Increased sensitivity to noise and light

Migraines without aura

It is also known as the "common migraine." Of the two, this type is the more frequent. They normally don't have signs before the migraine attack. Typical symptoms include:

• Sudden throbbing, intense headache pains that occur on one side of the head

• Nausea

• Confusion

• Mood changes

• Blurred vision

• Fatigue

• Sensitivity to sound and light

Other types of migraine

Other kinds of migraines include:

Abdominal migraines

This type of migraine mostly affects kids. A 2018 research³ on abdominal migraines revealed the condition normally manifests between the ages of four and 15. Commonality increases around the ages of 3–10 years, with peak incidence happening at the age of seven. 

Most patients have a familial or personal link with the condition. It has little in terms of headaches, but medium to severe discomfort is felt in the middle of the abdomen. Other symptoms include vomiting, loss of appetite, and nausea.

Hemiplegic migraines

It is a rare but serious kind of migraine. One experiences temporary paralysis on one side of the body during or before headaches. It further causes the following symptoms before the headache pains:

• Vertigo

• Difficulty speaking, seeing, or swallowing

• Trouble moving one half of the body

• A stabbing or piercing feeling in the head 

They usually clear up after the headaches cease. If this condition runs in the family, it's known as familial hemiplegic migraine (FHM).

Basilar-type migraines

This condition occurs more frequently among adolescents and children. It got its name as it was thought to be linked to basilar artery spasms. However, the connection between basilar migraines and vascular pathology has not been proven. They're now believed to be linked to nerves firing within the brainstem. 

Symptoms generally include:

• Dizziness

• Double vision, i.e., total or partial loss of sight

• Loss of balance

• Slurred speech

• Subpar muscle coordination

• Fainting

• Ringing in the ears

Differences and similarities between headaches and migraines

Most people wrongly view migraines as just strong headaches. While appearing similar at face value, the two are, in fact, very different conditions.

The differences

The following elements account for the differences between migraines and the other types of headaches:

Causes

As a primary type of headache disorder, a migraine occurs independently of other medical complications.

Related symptoms

Migraines have symptoms like sensitivity to light and sound, nausea, and a smattering of other indicators that differentiate them from other headaches.

Pain areas

Migraine headaches start on one side of the head and slowly spread to the other side throughout the attack. Tension headaches, on the other hand, have a band-like reach across the forehead. Sinus headaches are felt around the nose-bridge, cheek, and forehead region, while cluster headaches are concentrated behind the eye.

Diagnosis

Unlike headaches which are linked to medical conditions like trauma or tumors, migraines, being a primary headache disorder, cannot be diagnosed via blood or imaging tests.

The similarities

Here's how both conditions are similar:

Triggers

Migraines and tension headaches are triggered by anxiety and emotional stress — stimuli such as bright lights trigger cluster headaches and migraines. Many kinds of headache complications, migraines included, share dehydration as a possible trigger.

Period of illness

Migraines may last from a few hours (between four and 72 hours) to several days. This is the same case for other types of headaches like tension and cluster headaches.

The pain

Cluster headaches, migraines, and many other headaches are associated with pulsing or throbbing pain in the head.

Triggers

People who suffer from migraines and other headache complications tend to discover their symptoms worsen or begin due to certain conditions. These are what are called triggers. They may vary between individuals and can be anything from certain foods to environmental changes.

Common triggers include:

• Anxiety or depression

• Hormonal changes, either due to menstruation, menopause, or contraceptive use

• Hunger

• Lack of sleep

• Stress

• Beverages such as alcohol

• Exposure to allergens

Treatment

There's no permanent cure for migraines and headaches. Yet, this isn't to say the accompanying symptoms can't be treated or managed. The following practices may help you during a headache or migraine episode:

Over-the-counter (OTC) medication

Mild migraines and tension headaches can be relieved by using OTC drugs. A few good examples include:

Pain relievers

Nonsteroidal anti-inflammatory medications (NSAIDs), like ibuprofen and aspirin, and acetaminophen are good examples of common OTC pain relievers.

Melatonin

A 2017 research⁴ found that melatonin may be an effective tool for treating several types of primary headaches, particularly migraines and cluster headaches. It's advisable to talk with your doctor if you decide on this course of treatment to determine dosage issues, for instance.

Prescription medication  

Prescription medicine may be needed if the symptoms range from moderate to severe. Some of these include:

• Anti-nausea medications, promethazine (Phenergan) and chlorpromazine (Thorazine) are popular examples

• Triptans such as sumatriptan (Imitrex, Alsuma, and Zecuity), zolmitriptan, naratriptan, rizatriptan (Maxalt), frovatriptan, eletriptan, and almotriptan (Axert)

• Ergot alkaloids like ergotamine (Ergomar) and dihydroergotamine

Prevention

They say prevention is better than cure. It's better to manage symptoms and prevent future migraine and headache episodes. These measures are a combination of lifestyle changes and medication.

Preventing migraines

These strategies aren't limited to:

Medications

Prescription medications that can help prevent future migraines include antidepressants such as nortriptyline (Pamelor) or amitriptyline (Elavil), botulinum toxin A injections (Botox), and antiseizure drugs like sodium valproate (Depacon) and topiramate (Topamax).

Exercise

A regular workout routine aids with migraines by helping you sleep better and by managing obesity, which is a risk factor.

A good night's sleep

Sleep is quite important as it helps your body and mind recharge. This way, you're rested and alert for the following day. Sleep also aids your body in keeping healthy. Adults may endeavor to keep migraines at bay by sleeping seven or eight hours every night.

Relaxation

Proper relaxation routines like meditation, yoga, and regular exercise help relieve stress and mental tension, which are migraine triggers.

Keep a migraine journal

Make a record of your migraines, paying special attention to how long they last and how they feel. It's a way to identify your various triggers and track down the effectiveness of your treatments.

Preventing headaches

Preventing headaches necessitates the adoption of strategies almost similar to those used to prevent migraines. They include:

• Finding and enacting healthy techniques to ease tension and stress

• Having a regular eating and sleeping schedule

• Using the correct posture, especially if you're seated

• Taking long term headache medications as directed by the physician

When to see the doctor

Though headaches are common, it's best not to take them lightly; they may be identifiers of a serious issue. Going to your doctor for a checkup may help diagnose your migraines and headaches and possibly highlight any underlying medical conditions.

If you experience any of the following, seek medical care.

• You have difficulty moving or experience paralysis

• Problems articulating your words or understanding what's being said to you

• The pain, intensity, or length of the headache is abnormal

• If you're feeling confused or have different cognitive impairments

• Loss of balance or difficulty moving one side of your body

• A very out-of-the-blue headache

• Have relatively serious problems with your sight

The lowdown

Most of us will experience or have experienced a headache at one point or another. They will not all be the same and tend to vary in cause, frequency, and intensity. Headache disorders such as migraines can affect someone's capacity for normal operation and impact the overall quality of their life.

A well-informed diagnosis will help determine whether you have a migraine or a different kind of headache. Your doctor can then take you through appropriate treatment regimens and preventive measures.